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Professional Liability Insurance
Specialty Lines Insurance
Contact Us

Lawyers Professional Liability (LPL) Insurance
Premium Estimate Form

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Do not renew your LPL Insurance Coverage until you obtain a quote from PLCSI

For the past 40 years we have specialized only in professional liability insurance. We are Professional Liability Experts and Experts get results.

If you are serious in reducing your insurance costs while maintaining continuity of coverage, then you’ve come to the right place.

We are Recognized and Preferred Providers for:

Bronx County Bar Association
Westchester County Bar Association Recognized Provider
Women’s Bar Association of the State of NY

RECEIVE YOUR PREMIUM INDICATION NOW BY FILLING OUT THE FORM BELOW

OR CALL US AT 914-592-6505. WE ARE HERE TO HELP YOU!

Firm Information
Firm Name*
Address*
Street Address County City State ZIP Code
Phone*
Email*
Date of Establishment
MM slash DD slash YYYY
Contact Name*
Insurance History
Do you have current LPL insurance coverage?*
- Yes
- No
Current Carrier*
Current Expiration Date*
MM slash DD slash YYYY
Retroactive Date
MM slash DD slash YYYY

Current Limits
Please enter a number greater than or equal to 0.
Per Claim
/
Current Limits (Limit 2)
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Aggregate

Current Deductible
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Current Premium
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# of Expiring Attorneys
Please enter a number greater than or equal to 0.
Claim Expenses Outside Limit?*
- Yes
- No
- Unsure
Per Claim Deductible?*
- Yes
- No
- Unsure
First Dollar Defense Deductible?*
- Yes
- No
- Unsure
Aggregate Deductible?*
- Yes
- No
- Unsure
Attorney Information
Number of attorneys in the firm for 6+ years ^†
Please enter a number greater than or equal to 0.
Number of attorneys in the firm for 5 years ^†
Please enter a number greater than or equal to 0.
Number of attorneys in the firm for 4 years ^†
Please enter a number greater than or equal to 0.
Number of attorneys in the firm for 3 years ^†
Please enter a number greater than or equal to 0.
Number of attorneys in the firm for 2 years ^†
Please enter a number greater than or equal to 0.
Number of attorneys in the firm for 1 year ^†
Please enter a number greater than or equal to 0.
Number of attorneys in the firm for <1 year ^†
Please enter a number greater than or equal to 0.
Total # of Attorneys in the Firm ^†
Area of Practice Information
Must total 100%
Administrative Law
Please enter a number from 0 to 100.
%
Admiralty Law – Defense
Please enter a number from 0 to 100.
%
Admiralty Law – Plaintiff
Please enter a number from 0 to 100.
%
Adoption Law
Please enter a number from 0 to 100.
%
Antitrust/Trade Regulation
Please enter a number from 0 to 100.
%
Arbitration/Mediation
Please enter a number from 0 to 100.
%
Bankruptcy ^†
Please enter a number from 0 to 100.
%
Business Transactions & Contracts
Please enter a number from 0 to 100.
%
Cannabis Law ^†
Please enter a number from 0 to 100.
%
Civil Litigation – Defense
Please enter a number from 0 to 100.
%
Civil Litigation – Plaintiff ^†
Please enter a number from 0 to 100.
%
Civil Rights and Discrimination
Please enter a number from 0 to 100.
%
Class Actions/Mass Tort ^†
Please enter a number from 0 to 100.
%
Collection/Repossession – Commercial ^†
Please enter a number from 0 to 100.
%
Collection/Repossession – Consumer ^†
Please enter a number from 0 to 100.
%
Commercial Litigation – Defense
Please enter a number from 0 to 100.
%
Commercial Litigation – Plaintiff ^†
Please enter a number from 0 to 100.
%
Construction/Building Contracts
Please enter a number from 0 to 100.
%
Consumer Claims
Please enter a number from 0 to 100.
%
Corporate & Business Formation
Please enter a number from 0 to 100.
%
Corporate Mergers and Acquisitions
Please enter a number from 0 to 100.
%
Criminal
Please enter a number from 0 to 100.
%
Divorce – w/ Assets < $1M
Please enter a number from 0 to 100.
%
Divorce – w/ Assets $1M - $5M
Please enter a number from 0 to 100.
%
Divorce – w/ Assets > $5M
Please enter a number from 0 to 100.
%
Elder Law
Please enter a number from 0 to 100.
%
Eminent Domain
Please enter a number from 0 to 100.
%
Employment Law – Employee /Union ^†
Please enter a number from 0 to 100.
%
Employment Law – Employer/Management
Please enter a number from 0 to 100.
%
Entertainment ^†
Please enter a number from 0 to 100.
%
Environmental Law
Please enter a number from 0 to 100.
%
ERISA/Employee Benefits
Please enter a number from 0 to 100.
%
Financial Institutions/Banking ^†
Please enter a number from 0 to 100.
%
Government Contracts and Claims
Please enter a number from 0 to 100.
%
Guardianship/Juvenile
Please enter a number from 0 to 100.
%
Immigration and Naturalization
Please enter a number from 0 to 100.
%
Insurance Defense
Please enter a number from 0 to 100.
%
IP Copyrights & Trademarks ^†
Please enter a number from 0 to 100.
%
IP Patents ^†
Please enter a number from 0 to 100.
%
International Law
Please enter a number from 0 to 100.
%
Landlord/Tenant
Please enter a number from 0 to 100.
%
Local Government (not bonds)
Please enter a number from 0 to 100.
%
Oil & Gas ^†
Please enter a number from 0 to 100.
%
Personal Injury – Defense
Please enter a number from 0 to 100.
%
Personal Injury – Plaintiff ^†
Please enter a number from 0 to 100.
%
Real Estate – Commercial ^†
Please enter a number from 0 to 100.
%
Real Estate – Foreclosure ^†
Please enter a number from 0 to 100.
%
Real Estate – Land Use & Zoning ^†
Please enter a number from 0 to 100.
%
Real Estate – Residential ^†
Please enter a number from 0 to 100.
%
Real Estate – Title ^†
Please enter a number from 0 to 100.
%
Securities or Bonds ^†
Please enter a number from 0 to 100.
%
Social Security
Please enter a number from 0 to 100.
%
Taxation ^†
Please enter a number from 0 to 100.
%
Water Law
Please enter a number from 0 to 100.
%
Wills, Trusts & Estates < $1M ^†
Please enter a number from 0 to 100.
%
Wills, Trusts & Estates $1M - $5M ^†
Please enter a number from 0 to 100.
%
Wills, Trusts & Estates > $5M ^†
Please enter a number from 0 to 100.
%
Workers Compensation – Defense
Please enter a number from 0 to 100.
%
Workers Compensation – Plaintiff
Please enter a number from 0 to 100.
%
Other
Please enter a number from 0 to 100.
%
If other, describe:*
Total*
%
Fee Suit and Claim History Information
How many suits for fees have you filed against your clients in the last two (2) years?*
Please enter a number greater than or equal to 0.
Have any professional liability claims or incidents reported against any of the attorneys listed, prior partners or associates in the last 5 years? ^†*
- Yes
- No
If yes, please provide loss runs: ^†
Max. file size: 32 MB.
Have any of the firm’s attorneys been the subject of any disciplinary action, for any reason other than non-payment of dues, within the last ten (10) years? ^†*
- Yes
- No
^† We may need additional information to provide an estimate.
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Phone 914.592.6505 | FAX 914.592.6508
Email info@plcsi.com
Address 45 Knollwood Rd, Suite 202, Elmsford, NY 10523

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